BACKGROUND:
BACKGROUND: In Sweden, the Board of National Health and Wellfare recommend all elderly people (the 65 and over) to immunize against influenza each year and serious pneumococcal infektion every 7th year.

OBJECTIVE:
OBJECTIVE: The objectives of the survey were to identify the level of influensa and pneumococcal vaccination cover rate (VCR) in Uppsala County in 2003/2004 using two different methods of reporting.

METHOD:
METHODS: Physicians employed by the Uppsala County Council were asked to report to the County Medical Officer all influenza and pneumococcal vacinations performed during October and November on individuals who were 65 years or older. A telephone omnibus among 300 non-institutionalised individuals was also carried out.

RESULT:
RESULTS: In Uppsala County with 300 495 inhabitants, the elderly population comprises 43 132 individuals (14.3%). According to the physicians reports 14799 individuals received influenza vaccination (34%), increasing +1% in comparison to 2002/2003. According to the telephone omnibus the VCR for influenza was 42%. VCR in the elderly population in Uppsala County is much lower compared to the rest of Sweden (51%) or in other surveyed European countries (62%). The main reasons for non-vaccination among people who had never been vaccinated were not putting thought into action, lack of recommendation from the family physician or health-care personal, unlikelihood to catch the flu, unconcern, forgetfulness and not thinking that the vaccine is effective enough. High cost was rarly mentiond as a reason for non-vaccination.VCR for pneumococcal vaccination among the elderly increased +10% in comparison with 2002/2003, to reach 21% according to the physicians report whereas VCR was 30% according to the telephone survey.

CONCLUSION:
CONCLUSIONS: Both influenza and pneumococcal vaccination is highly underused in the elderly population in Uppsala County. There is a lack of knowledge regarding the positive effects of the combined vaccination upon morbidity and mortality of influenza-related infections. Educational campagnes direkted personaly to the elderly from their physicians or the CMO might increase vaccine uptake during winter 2004/2005.

LEARNING OBJECTIVES:
To understand factors and attitudes that influenses the acceptance rate of vaccination